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Individual & Family Products


How do I apply for CHIP?

There are three ways to apply for CHIP:


Paper Application

  • You may request an application be sent to you by e-mail. Include your name and mailing address in the e-mail.
  • Call 1.800.KIDS.101 (1.800.543.7101) to request an application be mailed to you.

How do I complete the application?

  • Complete one application which will cover all children who are under 19 years of age and living in the household.
  • Include the following individuals on your application, whether you are applying for them or not:
    • Yourself
    • Your spouse or unmarried partner
    • Anyone under 21 who lives with you
    • Anyone you include on your tax return, even if they don’t live with you
  • Be sure to answer all questions. An incomplete application will delay processing.
  • If any documentation is needed in order to process the application, it will be noted on the application.

Apply Online